HCPCS code J2993: Reteplase injection, per 18.1 mg2026 Medicare rate & RVUs in Texas
Reteplase is an intravenous clot-dissolving drug used for acute myocardial infarction; report this code for each 18.1 mg administered.
CMS doesn’t publish an office rate for J2993 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What J2993 covers
Reteplase is an intravenous thrombolytic used to dissolve blood clots in adults with acute myocardial infarction, particularly ST-elevation myocardial infarction. It is generally administered by a clinician in an emergency department, hospital, or other acute-care setting. The usual treatment is two intravenous bolus doses, given 30 minutes apart. This drug code represents the medication, not the clinical work of diagnosing or treating the heart attack.
CMS assigns status E, excluding the code from the physician fee schedule. When Medicare covers the drug, payment is generally determined under the Part B drug method using CMS’s quarterly Average Sales Price pricing files. Special Medicare coverage instructions apply. One HCPCS unit represents 18.1 mg of reteplase; report units based on the documented amount administered. A usual two-dose treatment contains 36.2 mg total, or two units.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where J2993 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
How the J2993 rate is calculated
Each of J2993’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · J2993
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for J2993
J2993 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · J2993
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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J2993 isn’t priced in this setting.
J2993 compared with similar codes
Compare codes · National
J2993 vs J2997 vs J3101: Medicare rates
How to choose
- J2997Alteplase injectionPer 1 mg
- J2993 is for reteplase; J2997 is for alteplase. Select the code for the specific drug administered, not simply the thrombolytic treatment.
- J3101Tenecteplase injectionPer 1 mg
- J3101 identifies tenecteplase, not reteplase. These are distinct thrombolytic drugs with separate HCPCS codes.
J2993 billing questions
How many units represent a usual reteplase treatment?
One unit represents 18.1 mg. The usual two-dose treatment totals 36.2 mg, or two units; report the amount documented as administered.
How does this code differ from J2997 for alteplase?
J2993 identifies reteplase, while J2997 identifies alteplase. They are different thrombolytic drugs, and this code should reflect the drug actually administered.
Does Medicare pay J2993 under the physician fee schedule?
No. CMS assigns status E, excluding it from the physician fee schedule. When Medicare covers the drug, it generally uses the Part B drug pricing method based on quarterly ASP files.
What should the record support when reporting units?
Document the drug administered and the amount given. Calculate units using 18.1 mg per unit.
Does J2993 include the work of administering reteplase?
J2993 identifies the drug. It does not itself identify the clinical work of treating the myocardial infarction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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